Living Liver Donation

A person may need a living donor when their liver disease is advanced and waiting for a deceased donor liver would be too long or risky. A donor may be a relative, spouse or friend. Basic requirements are that the donor is an adult, in good general health, with a compatible blood group and a suitable liver size and anatomy, who understands the risks and agrees freely. People with significant illness, severe obesity, active infection, certain liver conditions, or who are pressured to donate are not suitable.

Living donation is an important option where deceased donor livers are limited. It is done in specialised transplant centres. Not everyone who offers to donate is suitable, and many potential donors are found unsuitable or decide not to proceed. That is a normal part of the process.

Living donation is usually from close relatives. Family expectations can create pressure, so it is important that the decision is truly your own. The transplant centre will explain the legal and ethical requirements and offer private discussions with the donor team.

Potential donors go through a careful, staged assessment that is separate from the recipient's care, with the aim of protecting the donor. It includes blood tests (blood group, liver, kidney, infections), imaging (CT or MRI) to measure the liver and map its blood vessels and bile ducts, heart and lung tests, screening for other diseases, and a review with a psychologist or social worker to make sure the decision is free and informed. An independent team advocates for the donor. A donor can say no or change their mind at any time without needing to give a reason, and the team will protect their privacy.

Preparing physically and emotionally helps recovery. Your own safety is the priority.

• Take your time with the decision; you may withdraw at any stage.

• Stop smoking and avoid alcohol before and after surgery.

• Reach and keep a healthy weight as advised by the team.

• Plan time off work, help at home and transport for the recovery period.

• Avoid heavy lifting and strenuous exercise until the surgeon says it is safe.

• Attend all follow-up visits, including long-term check-ups.

A balanced diet helps healing and liver regrowth. A dietitian can advise you.

• Eat enough protein and calories as you recover; small frequent meals help while appetite is low.

• Eat plenty of vegetables, fruit and whole grains; drink enough fluids.

• Avoid alcohol, and do not take herbal or "liver" supplements unless the team approves.

• Follow food safety rules while recovering, particularly with raw or undercooked foods.

Donors do not need anti-rejection medicines. After surgery, medicines are used for pain, nausea and prevention of clots or infection as decided by the team.

• Take pain medicine as advised and ask which ones are safe for the liver; avoid extra over-the-counter painkillers unless the team agrees.

• Medicines to reduce clot risk may be given in hospital and sometimes afterwards.

• Tell the team about all medicines and supplements you take before donation, since some must be stopped.

• Report any new medicine side effects or symptoms early.

Donation is performed under general anaesthesia by an experienced liver surgery team. The recipient's operation takes place at the same time in a nearby theatre.

• The surgeon removes a part of the donor's liver (the right lobe, the left lobe or a smaller section depending on the recipient's needs).

• Hospital stay is usually several days, with recovery at home over weeks; full return to normal activity often takes a few months.

• Risks include bleeding, infection, bile leak or narrowing, blood clots, problems with anaesthesia, wound problems and, rarely, liver failure or death; your team will discuss them honestly.

• Some people have a visible scar and some have long-term pain or numbness near it.

Programmes continue to improve donor safety with careful selection, imaging and, in some centres, minimally invasive surgery. Even so, living donation always carries a real risk for the donor, including rare serious complications, and the exact risk depends on the type of operation and the centre. Ask the team for current figures from their own programme rather than relying on general numbers.

Most donors recover well and return to normal activities after a period of recovery, usually many weeks. The liver regrows, and long-term follow-up checks health. Some donors have lingering tiredness, pain or emotional effects, and complications can occur. Being well informed and supported before and after donation helps.

• What are the exact risks for me as a donor at this centre?

• How much of my liver will be removed, and will it regrow?

• How long will recovery take, and when can I return to work?

• Who will look after me independently of the recipient's team?

• What follow-up will I need, and can I change my mind?

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.